Organization Active NPI

Active Care Manayunk

  • Chiropractor
  • Philadelphia, PA
National Provider Identifier
1003631128
Registry record updated Nov 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
ACTIVE CARE MANAYUNK
Practice address
4368 Cresson St
Philadelphia, PA 19127-1460
Phone
(215) 617-9719
Fax
(215) 827-5606
NPI assigned
Nov 22, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Maya Wilson
Title
Manager
Phone
(215) 595-3946

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

4368 Cresson St
Philadelphia, PA 19127-1460

Mailing address

414 Randall Rd
Wyncote, PA 19095-2106
Phone (610) 216-3277

National Provider Directory

National Provider Directory

Locations

4368 Cresson St
Philadelphia, PA 19127
Phone (215) 617-9719

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1732233600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732233600000",
    "number": "1003631128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "414 RANDALL RD",
            "city": "WYNCOTE",
            "state": "PA",
            "postal_code": "190952106",
            "telephone_number": "610-216-3277",
            "fax_number": "215-827-5606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4368 CRESSON ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191271460",
            "telephone_number": "215-617-9719",
            "fax_number": "215-827-5606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACTIVE CARE MANAYUNK",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-22",
        "last_updated": "2024-11-22",
        "certification_date": "2024-11-22",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "MAYA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "215-595-3946"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.